Last night I went to a private doctor about an hour away to get another opinion on the health of my baby. I explained to her the the heart beat had been fabulous for 37 weeks and I couldn't understand why it was such a problem now and wasn't there a possibility the problem was with equipment/over anxiety/medical profession need to cut people up driving this issue more than a genuine medical issue?
I explained I REALLY HATE the thought of getting a c-section, hate it more than words can express, and am willing to undergo whatever procedure necessary to prove we are both strong and healthy enough to have a natural unaugmented birth.
the doctor looked at me and said, "I'm going to be totally honest with you. you are obese. Cesareans are extremely dangerous for obese women for a variety of reasons, much more dangerous for both baby and mother than a natural birth. Trust me, NO doctor in Hong Kong wants to perform a C-section on someone like you. You are very high risk for this procedure, and so especially NO doctor in the PUBLIC hospitals want to be the ones to perform your cesarean..it will be longer, harder, riskier, and they won't get paid more for it. If a group of four doctors in a PUBLIC hospital are recommending you to get one, they are doing so despite knowing how hard it's going to be for them to perform one."
I couldn't help myself, and started to cry a bit. it was so not what I wanted to hear. But I knew I needed to hear it. On the one hand, it did make me feel better that the doctors weren't being knife-happy cowboys licking their chops at the thought of getting to cut me open. they were advising me to let them do something they didn't want to do any more than i wanted them to do it.
On the other hand, i hadn't considered the thought that my cesarean would be any more dangerous than any one else's, but it makes sense. having to slice through a layer of fat makes it easier to make a mistake and cut too deeply or cut the wrong thing, it makes the sewing up process harder and longer and more at risk of infection. i will require more anesthesia, which brings a host of it's own complications. i was scaring myself silly imagining all the things that could go wrong and I started to feel so sorry for myself i couldn't hold back the waterworks.
then she asked me to hop up on the bed/table thingy and we can at least have a look. As i suspected, her equipment was significantly more sophisticated then what they had at Tuen Mun public Hosp and I was even allowed to see the baby for myself (somthing the public hosp couldn't be bothered with showing me, despite requests to see for myself) and i even got pics, something TMH doesn't give out to patients.
After some time, she told me they were right; the quality and amount of the fluid in the sac was poor and the heartbeat irregular and combined, that indicated a serious enough problem to warrant a cesarean, rather than risk the baby having a cardiac arrest in the middle of labor. Again, NOT what I wanted to hear.
She also advised me to schedule one in advance, rather than wait for an emergency cesarean, because in an emergency, I'll be stuck with whomever is on duty at the time, versus a scheduled procedure where they will probably try to find a doctor with a good long record of successful high risk cesareans to take me, to reduce the personal risk to me ( and to the hospital).
I left feeling awful, worried, and so sorry for myself. But also more at peace with the procedure, that it really truly is in the best interest of the baby. My son taught me long ago that it's not about me anyway. it hasn't been about me for 6 years, and it's not about me now. I need to buck up, suck it up, and get a grip.
I need to make a plan and figure out what it will all mean after the procedure is done. breastfeeding will be significantly harder because we will be separated while I'm being sewed up, and they will be performing diagnostics to see if the heart problem is self-correctable or will need further medical intervention. She will probably be given a bottle by the nurses at some point. i know where this road leads. To combat it, I'm going to have to work very hard, even though it's harder to hold a baby when recovering from a cesarean, harder to get around, harder to do everything the first few weeks. I need to prepare myself for that, literally, and mentally.
I have another diagnostic appointment at TMH on Monday. if they tell me I need a c-section, I will accept this advice and do what I have to do.
Finally, the private doctor was able to determine something no one at the public hospital could tell me: the baby's gender. So I finally know, just literally days before she is born, that she is, indeed, a girl.
Wednesday, November 23, 2011
Monday, November 21, 2011
health in HK part...i don't even know anymore!
Last night I was in the hospital for six hours while four doctors deliberated over whether or not they should slice me open right then and there or if they could wait a week before slicing me open. meanwhile, i was asking if there was any way I could avoid being sliced open at all.
You see, I have always sincerely believed women are made to safely carry, birth, and feed human babies, whereas they are NOT made to safely be sliced open, ever. the more i learn about cesareans, the more I realize how dangerous a surgery it is, and how grave a decision to have one is.
The thing is, people think about it as being more like rhinoplasty. Rhinoplasty is a fantastic reconstructive tool when you get into an accident or something goes horribly wrong in fetal development, but most often it is completely medically unnecessary, brings with a host of potential complications, and the person who gets it is often worse off for having had it done. Who things Michael Jackson's nose jobs did him any favors?
But the majority of people don't consider these complications and side effects and go into these surgeries as if they were about to get a tooth pulled. "Hmm....Tuesday sounds nice, I'll get it done before the in-laws come to town and then we'll all have a party!"
Doctors, too, are far too complacent about cesareans. basically i think nurses and doctors are knife-happy cowboys who believe cutting people open is the answer to most problems, but somehow they are far more blase (I wish i could make French accents) about C-sections than other operations. And yet, the 6-8 week recovery period, and the variety of potential complications that are more common than in a regular birth, are certainly nothing to sneeze at.
And yet, when truly medically necessary, operations are life savers. So i was trying to determine if my baby's irregular heartbeat, which had been regular and strong and perfect for the past 37 weeks, was truly a medical emergency or if it was a temporary glitch in the heart-brain communications department and would sort itself out on it's own. We listened for hours, and watched on the ultrasound, and switched machines several times to make sure it wasn't a glitch in the machinery, but truly, the heart, so perfect until now, just couldn't get it's act together.
of course, i wanted to know why a perfect heart would suddenly be a problematic one, and they didn't know. I asked if it could self correct, and they said it's possible, but they didn't know. I asked how many babies with irregular heartbeats survive normal deliveries and they didn't know. What they DID know is that sometimes babies with irregular heartbeats DIDN'T survive normal deliveries. Why is it doctors never know when you ask them how normal something is, but always know when you ask them how abnormal something is? Why all this bias for the abnormal?
Google wasn't any more helpful. i found lots of literature about how babies with irregular heartbeats are delivered by cesarean, but i couldn't find a thing about whether this was necessary, how often it self-corrected and made c-sections unnecessary, or how many women delivered happy healthy babies naturally anyway. I want to do what's best, but it's hard to know what's best when you are only given one side of the argument.
the other issue is that there is almost no amniotic fluid in the sac, just like with Kai. i was disappointed to hear this, because my experience with Kai and his dehydration taught me to really go wild on the liquids, and I've been drinking crazy amounts of water/fluids for all nine months, and was told last night the amount of water I drank had no influence on the fluid levels of the amniotic sac; it all depended on the health and general condition of the baby. it was the combination of the poor amniotic sac condition and the irregular heartbeat that concerned the doctors.
I do have to say, I feel better that four doctors and three nurses consulted together and watched me for hours before concluding a C would be best. And they laid out the options:
1. have a c section/induction right there and now and let them have at the baby.
2. Wait a week and see if it self corrects, then have a C section, or an induction ( i also am opposed to inductions, because I had this done before and I know what utter crap that turns into)
3. Wait two weeks, but if it does not self correct, i will not even have natural delivery as an option.
4. let the body progress naturally, natural onset and delivery in 2-4 weeks time, but if the heart has not self-corrected, the likelihood is high that the baby would not survive the stress.
But even so, I would have liked at least one of the doctors to have been older than I. Someone who had delivered 1,000 babies and had seen everything and knew what the real range of normal looked like. Just because something isn't textbook perfect doesn't mean it's abnormal, or dangerously different. I'm going to try between now and next week to find someone with a little more experience assess the situation and tell me honestly what is necessary and what is not. And find my peace with whatever I need to do.
You see, I have always sincerely believed women are made to safely carry, birth, and feed human babies, whereas they are NOT made to safely be sliced open, ever. the more i learn about cesareans, the more I realize how dangerous a surgery it is, and how grave a decision to have one is.
The thing is, people think about it as being more like rhinoplasty. Rhinoplasty is a fantastic reconstructive tool when you get into an accident or something goes horribly wrong in fetal development, but most often it is completely medically unnecessary, brings with a host of potential complications, and the person who gets it is often worse off for having had it done. Who things Michael Jackson's nose jobs did him any favors?
But the majority of people don't consider these complications and side effects and go into these surgeries as if they were about to get a tooth pulled. "Hmm....Tuesday sounds nice, I'll get it done before the in-laws come to town and then we'll all have a party!"
Doctors, too, are far too complacent about cesareans. basically i think nurses and doctors are knife-happy cowboys who believe cutting people open is the answer to most problems, but somehow they are far more blase (I wish i could make French accents) about C-sections than other operations. And yet, the 6-8 week recovery period, and the variety of potential complications that are more common than in a regular birth, are certainly nothing to sneeze at.
And yet, when truly medically necessary, operations are life savers. So i was trying to determine if my baby's irregular heartbeat, which had been regular and strong and perfect for the past 37 weeks, was truly a medical emergency or if it was a temporary glitch in the heart-brain communications department and would sort itself out on it's own. We listened for hours, and watched on the ultrasound, and switched machines several times to make sure it wasn't a glitch in the machinery, but truly, the heart, so perfect until now, just couldn't get it's act together.
of course, i wanted to know why a perfect heart would suddenly be a problematic one, and they didn't know. I asked if it could self correct, and they said it's possible, but they didn't know. I asked how many babies with irregular heartbeats survive normal deliveries and they didn't know. What they DID know is that sometimes babies with irregular heartbeats DIDN'T survive normal deliveries. Why is it doctors never know when you ask them how normal something is, but always know when you ask them how abnormal something is? Why all this bias for the abnormal?
Google wasn't any more helpful. i found lots of literature about how babies with irregular heartbeats are delivered by cesarean, but i couldn't find a thing about whether this was necessary, how often it self-corrected and made c-sections unnecessary, or how many women delivered happy healthy babies naturally anyway. I want to do what's best, but it's hard to know what's best when you are only given one side of the argument.
the other issue is that there is almost no amniotic fluid in the sac, just like with Kai. i was disappointed to hear this, because my experience with Kai and his dehydration taught me to really go wild on the liquids, and I've been drinking crazy amounts of water/fluids for all nine months, and was told last night the amount of water I drank had no influence on the fluid levels of the amniotic sac; it all depended on the health and general condition of the baby. it was the combination of the poor amniotic sac condition and the irregular heartbeat that concerned the doctors.
I do have to say, I feel better that four doctors and three nurses consulted together and watched me for hours before concluding a C would be best. And they laid out the options:
1. have a c section/induction right there and now and let them have at the baby.
2. Wait a week and see if it self corrects, then have a C section, or an induction ( i also am opposed to inductions, because I had this done before and I know what utter crap that turns into)
3. Wait two weeks, but if it does not self correct, i will not even have natural delivery as an option.
4. let the body progress naturally, natural onset and delivery in 2-4 weeks time, but if the heart has not self-corrected, the likelihood is high that the baby would not survive the stress.
But even so, I would have liked at least one of the doctors to have been older than I. Someone who had delivered 1,000 babies and had seen everything and knew what the real range of normal looked like. Just because something isn't textbook perfect doesn't mean it's abnormal, or dangerously different. I'm going to try between now and next week to find someone with a little more experience assess the situation and tell me honestly what is necessary and what is not. And find my peace with whatever I need to do.
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